Purpose
The aim of this study was to examine the hormonal profile in early-pubertal girls with obesity. We hypothesized that these patients might already present hormonal alterations with POCS-like ...features.
Methods
Cross-sectional study in a sample of 283 peri-pubertal girls (prepubertal and early-puberty subgroups), aged 6.1–12.0 years, diagnosed with obesity (BMI-SDS > 2.0, 97th percentile), so-called obesity group. They all underwent clinical examination and blood testing for hormonal measurements (leptin, TSH, FT4, IGF-1, IGFBP3, prolactin, insulin, FSH, LH, estradiol, ACTH, cortisol, 17-OH-P, DHE-S, androstenedione, testosterone and free testosterone). A control group was recruited: 243 healthy girls, aged 6.3–12.1 years, with normal BMI status.
Results
Prepubertal girls with obesity had significantly higher values (
p
< 0.05) for BMI-SDS, leptin, insulin and HOMA-IR levels than control group. Early-pubertal girls with obesity also had significantly higher values (
p
< 0.05) for BMI-SDS, leptin, IGF-1, IGFBP3, insulin and HOMA-IR, LH, ratio LH/FSH, ACTH, DHE-S, androstenedione, testosterone and free testosterone levels than control group. In early-pubertal girls with obesity (not prepubertal girls), there was a positive correlation (
p
< 0.01) between leptin levels with LH, androstenedione and testosterone, and HOMA-IR with LH and testosterone levels. There was also a positive correlation (
p
< 0.01) between IGF-1 levels with LH, androstenedione, DHE-S and testosterone; and LH levels with testosterone.
Conclusion
The results obtained support our hypothesis that an abnormal hormonal profile with POCS-like features can already be detected (insulin resistance and hyperinsulinemia, increased secretion of LH and ACTH, and overproduction of ovarian and adrenal androgens) in early-pubertal girls with obesity.
Purpose
The objective of this study was to analyze vitamin D status and PTH concentrations in 6- to 8-year-old girls with central precocious puberty.
Methods
A cross-sectional clinical and blood ...testing study (calcium, phosphorus, 25(OH)D and PTH) was carried out in 78 girls with central precocious puberty (CPP group), aged 6.1–7.9 years. A control group was recruited (137 prepubertal girls, aged 6.1–8.2 years). The criteria of the US Endocrine Society were used for the definition of hypovitaminosis D.
Results
There were no significant differences in vitamin D status between both groups. There were no significant differences in 25(OH)D concentrations between CPP (25.4 ± 8.6 ng/mL) and control groups (28.2 ± 7.4 ng/mL). In contrast, PHT concentrations in CPP group (44.8 ± 16.3 pg/mL) were higher (
p
< 0.05) with respect to control group (31.0 ± 11.9 ng/mL). In CPP group, there was a positive correlation (
p
< 0.05) between PTH concentrations and growth rate, bone age, and basal estradiol, basal FSH, basal LH and LH peak concentrations.
Conclusion
Vitamin D status in 6- to 8-year-old girls with CPP is similar to that in prepubertal girls. PTH concentrations were significantly higher in girls with CPP, and this could be considered as a physiological characteristic of puberty and, in this case, of pubertal precocity.
Background: The aim of this study was to analyze the epidemiologic, clinical, and evolutional characteristics in patients who presented convulsions with mild gastroenteritis (CwG) to facilitate the ...diagnosis in daily clinical practice.
Methods: Twenty‐five medical records of patients diagnosed with CwG were reviewed, and the epidemiological and clinical features, results of complementary studies, and evolutional data were collected.
Results: Age of onset ranged between 12 and 24 months in 76% of patients. Female/male ratio was 2.6 (18 women and seven men). Seizures were mostly brief (<5 min) and apparently generalized, and often repetitive occurring in cluster (2.2 seizures per episode). One patient with status epilepticus was recorded. The average interval between the onset of gastroenteritis and seizures was 3.8 days, even though seizure preceded diarrhea in three cases. Mean rectal temperature at the moment of seizure was 37.1°C. Rotavirus antigen was positive in stool in 17 episodes (55.8%). There were no abnormalities in serum biochemistry tests and cerebrospinal fluid studies. Four patients showed anomalies in the interictal electroencephalogram. The period of follow‐up was 4.2 years. Five patients (20%) experienced recurrences when suffering a new gastroenteritis episode. One patient developed epilepsy during the follow‐up period.
Conclusions: CwG would constitute a well‐differentiated convulsive syndrome. Prognosis is excellent, but a relatively important percentage of patients relapse when suffering a new diarrhea episode.
Purpose
To analyze whether vitamin D deficiency could condition the growth response to GH therapy, as well as to analyze if GH treatment modifies both seasonal variations and vitamin D levels in ...these patients.
Methods
Retrospective study in 98 prepubertal children with GH deficiency (GHD), aged 4.1–8.9 years treated with GH. Growth rate and blood testing (calcium, phosphorus, IGF-I, 25(0H)D and PTH) were monitored at diagnostic and every six months until 24 months of treatment. A control group was recruited (247 healthy children, aged 3.8–9.7 years). The criteria of the US Endocrine Society were used for the definition of hypovitaminosis D.
Results
There were no significant differences in vitamin D deficiency among control (12.5%) and GHD groups (15.3%) before starting treatment. Growth rate and IGF-1 and PTH increased (
p
< 0.05) during GH treatment, but there were no significant differences in calcium, phosphorus and 25(OH)D. There were no significant differences in growth rate and IGF-1, calcium and phosphorus levels in relation to the seasons along GH treatment. There was no correlation between 25(OH)D and IGF-1 during GH therapy. In every programmed control, patients with vitamin D deficiency showed lower growth rate (
p
< 0.05) compared to patients with vitamin D insufficiency or sufficiency.
Conclusion
GH treatment, at least during the first two years, does not modify the vitamin D levels. Vitamin D deficiency could condition the response to GH therapy so vitamin D monitoring should be considered as part of the routine evaluation of children with GH treatment.
Vitamin D deficiency may contribute to endocrine health and disease (diabetes, autoimmune thyroid diseases, polycystic ovarian syndrome, etc.). The aim of this study was to determine the prevalence ...and specific factors for hypovitaminosis D among children stratified by body mass index (BMI) in Northern Spain.
A cross-sectional clinical (sex, age, season of study visit, place of residence and BMI) and blood testing (calcium, phosphorous, calcidiol and parathyroid hormone (PTH)) were accomplished in 546 Caucasian individuals (aged 3.2-15.8 years). The BMI (Z-score) allowed establishing four groups: normal, overweight, obesity and severe obesity. The criteria of the US Endocrine Society were used for the definition of hypovitaminosis D.
Calcidiol levels were significantly higher in normal and overweight groups (P=0.001), whereas PTH levels were significantly higher in obesity and severe obesity groups (P=0.001). Hypovitaminosis D prevalence was significantly higher in severe obesity (81.1%) and obesity (68.2%) groups, whereas was lowest in overweight (55%) and normal (58.1%) groups (P=0.001). There was a negative correlation between calcidiol and PTH levels (P<0.01). Female (90.9%), adolescent group (88,2%), winter (100%) and autumn (82.4%) time and urban residence (94.1%) imply a higher prevalence of hypovitaminosis D in subjects with severe obesity (P<0.001). Female, puberal age, autumn, winter and spring time, urban residence and severe obesity were found to be independent predictors for hypovitaminosis D.
Severe obesity could be considered as an associated factor for vitamin D deficiency, and, owing to its high prevalence, the implementation of systematic screening and hypovitaminosis treatment programs would be particularly useful.
Background and purpose: The aim of this study is to analyze the proportional distribution of epilepsy and epileptic syndromes in children and to describe the magnetic resonance imaging (MRI) ...abnormalities found in these patients.
Methods: Data from 457 children aged 1 month to 15 years at the time of diagnosis of epilepsy were recorded. A routine MRI has been requested in all patients with epilepsy at diagnosis according to a standardized pediatric seizure protocol. Abnormalities on MRI were classified as either significant or non‐significant (standardized scoring system). International League Against Epilepsy criteria were used for diagnoses.
Results: The prevalence of significant MRI abnormalities was 21.9% (in infants 42.3%, in childhood 18.2%, and in adolescents 15.9%). The most common abnormalities included white‐matter lesions (27.6%), volume loss (19.6%), gray‐matter lesions (19.6%), and ventricular enlargement (12%).
Conclusions: The use of MRI and a reliable standardized scoring system at diagnosis of epilepsy in children identified a high rate of significant abnormalities findings. This may have important implications for practice guidelines in this population.
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To carry out a descriptive study on the breakfast model in a college population and to analyze the energy and nutrients provided, in connection with established nutritional requirements.
Registry of ...food intake for breakfast (on rising and mid-morning snack) of a school day in a sample of 740 college students (286 men and 454 women) with ages ranging 19-24 years. Gender, age, weight, height, and body mass index, and type of residence were collected from each interviewee. Percentages intakes of nutrients have been calculated in proportion to established dietary recommendations (%IR).
93.2% had breakfast on rising and 83.8% took a mid-morning snack daily, and 53.5% do both intakes. The most common foods were dairy products (92.6%), cereals (58.8%) and sweet food (57.9%) at breakfast, and cereals (46.6%), fruits (40.7%) and sausages (34.9%) at mid-morning. The %IR of the calorie intake was 24.4% in males and 24.6% in females (n.s.). The %IR of the cholesterol intake was 38.2% in males and 23.9% in females (p < 0.05). The %IR for minerals and vitamins were greater (p < 0.05) in early breakfast.
This breakfast model differs from the prototype of a healthy diet through an excessive consumption of sweet foods (early breakfast) and meat and derivatives (snack). Half of interviewee did not a mid-morning snack and the morning caloric intake was below recommended. In the case of university students concerned about the potentially negative effect it may have on academic performance.
The aim of this study was to analyse the epidemiological, clinical and evolutional characteristics of Panayiotopoulos syndrome (PS) in order to facilitate the diagnosis in daily clinical practice. ...Thirty‐seven medical records of patients diagnosed with PS were reviewed and the epidemiological and clinical features, results of complementary studies and evolutional data were collected. Mean age at diagnosis was 5.4 years. Female/male ratio was 2.1. The majority of seizures occurred during sleep (67.2%). They usually begin with autonomic manifestations or vomiting (70.1%). Ictal eye and/or cephalic deviation and progression to partial or generalized convulsions were also quite frequent. EEG showed occipital spikes in 28 patients (75.7%). Besides, 71.3% of recurrences were observed in the first 6 months after diagnosis, and 82.9% of the patients had no seizures beyond 2 years from diagnosis. One patient with an atypical development was recorded. The PS is a relatively frequent epileptic syndrome in paediatric age, especially in pre‐school children. Although its semiological sequence is fairly typical, the unspecific clinical and neurological characteristics complicate the diagnostic suspicion. Prognosis is excellent; however, it would be convenient to keep a strict evolutional follow‐up in these patients as an atypical evolution might occur.
To analyze the chronological evolution of excess body weight (overweight and obesity) in order to raise public awareness within the different areas of intervention (family, school, business ...environment, health services) and to take effective actions.
Weight, height and body mass index (BMI) of 604 healthy subjects (307 males and 297 females) have been recorded at birth and at the age of 1, 2, 3, 4, 6, 8, 10, 12 and 14 years. The excess body weight has been calculated according to national references from Ferrández et al.
Prevalence of excess body weight at age 14 years was significantly higher (P<.05) in males (29%) than in females (12.8%). BMI (kg/m2) was significantly higher (P<.05) for both sexes in every age period, except for birth and age 1 year, in those patients with excess body weight at age 14, with respect to patients with normal nutritional status of the same age. Those groups with excess body weight at age 14 showed a BMI (Z-score) reaching overweight or obesity levels at age 4, and progressively increasing.
Excess body weight probably starts at early stages in life, when dietary habits of the child depends almost exclusively on family habits, and may be aggravated during school attendance. Finally, a disproportionate weight increase occurs in adolescence that is probably related to unhealthy dietary habits and way of life.
To evaluate the dietary patterns in a group of patients diagnosed with attention deficit hyperactivity disorder (ADHD) and under treatment with extended-release methylphenidate (MPH-ER).
A nutrition ...survey (food intake recall for three consecutive days) was carried out on 100 patients diagnosed with ADHD and under treatment with MPH-ER, and in 150 healthy children (control group). Calorie and nutrient intake, as well as nutrition status, were evaluated and compared in both groups.
The mean MPH-ER dose was 1.02 mg/kg/day. Nutritional status in the ADHD group was significantly lower (P < .05) than in control group. The consumption of cereals, meat, pulses and fruits in the control group was significantly higher (P < .05) than in ADHD group. Calorie intake in the mid-morning snack, lunch and afternoon snack was significantly higher (P < .05) in the control group. Calorie intake at supper was significantly higher (P < .05) in the ADHD group. Total calorie intake, as well as protein, carbohydrates, fat, fibre, calcium, iron, magnesium, zinc, selenium and phosphorous, thiamine, niacin, vitamin B6 and folate intake in the control group was significantly higher than in ADHD group.
Treatment with MPH-ER substantially modifies the percentage distribution of calorie intake of the different meals. The daily calorie and nutrients intake in patients under treatment with MPH-ER is, generally, lower than in the healthy population of a similar age. Nutrition education should be provided, along with multimodal treatment, to the patients and/or their families.
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